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Inflammatory Myofibroblastic Tumor of the Urinary Bladder and Ureter in Children: Experience of a Tertiary Referral Center

  • Yun-peng Li
    Affiliations
    Department of Urology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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  • Wen-wen Han
    Affiliations
    Department of Urology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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  • Yang Yang
    Affiliations
    Department of Urology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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  • Le-jian He
    Affiliations
    Department of Pathology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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  • Wei-ping Zhang
    Correspondence
    Address correspondence to: Wei-ping Zhang, MD, PhD, Department of Urology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No. 56 Nanlishi St, Xicheng District, Beijing, 100045 China.
    Affiliations
    Department of Urology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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      Purpose

      To present the clinicopathological characteristics and outcome of children with bladder and ureteral inflammatory myofibroblastic tumors (IMTs) in our center.

      Methods

      We reviewed the medical records of patients with bladder and ureteral IMTs from 2010 to 2018. We recorded patients’ demographic data, presentation, hemoglobin level, presence of hydronephrosis, tumor size, treatment, and outcomes.

      Results

      Eight patients with bladder IMTs and 3 with ureteral IMTs were treated at our center during this period. The mean age was 7.1 years. Four patients presented with anemia at diagnosis with the mean hemoglobin level 84.5 g/L. Among patients with bladder IMTs, 5 were male and 3 were female. The most common symptom was lower urinary symptoms in 6 patients, followed by hematuria in 4 patients. 2 patients had complications of hydronephrosis and hydroureter. Among patients with ureteral IMTs, 2 were male and one was female. The most common symptom was abdominal pain, and 3 patients presented with upper urinary tract dilation. All patients underwent surgery. A total of 81.8% were positive for anaplastic lymphoma kinase. Cytokeratin (CK) expression was present in all patients with bladder IMTs, while it was negative in 2 patients with ureteral IMTs. During mean follow-up of 43.4 months, all patients survived event-free.

      Conclusion

      The presence of hydronephrosis and hydroureter is rare in patients with bladder IMTs. Anemia caused by hematuria should be raised the index of suspicion for IMTs. Children with bladder and ureteral IMTs had excellent prognosis. The expression pattern of CK varied between bladder and ureteral IMTs.
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